| NPI | 1831500933 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618002858) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: GA OPT2840) |
| Enumeration Date | 2014-05-12 |
| Last Update Date | 2020-08-18 |